Asbestosis and Idiopathic Pulmonary Fibrosis: Comparison of Thin-Section CT Features

S.J. Copley, A.U. Wells, P. Sivakumaran, M.B. Rubens, Gary Lee, S.R.D. Desai, S.L. Macdonald, R. Thompson, A.G. Nicholson, R.M. Du Bois, Arthur Musk, D.M. Hansell

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101 Citations (Scopus)

Abstract

PURPOSE: To identify differences, if any, in thin-section computed tomographic (CT) features between asbestosis and idiopathic pulmonary fibrosis (IPF) and to test the findings in a subset of histopathologically proved cases of usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP).MATERIALS AND METHODS: Consecutive patients with a diagnosis of IPF (n 212) or asbestosis (n = 74) were included. The relationships derived from the initial comparison were tested in a separate group of biopsy-proved UIP (n = 30) and NSIP (n = 23) cases. Two observers independently scored thin-section CT images for extent, distribution, and coarseness of fibrosis; proportion of ground-glass opacification; severity of traction bronchiectasis; and extent of emphysema.RESULTS: After controlling for extent of fibrosis, patients with asbestosis had coarser fibrosis than those with IPF (odds ratio, 1.52; 95% CI: 1.25, 1.84; P < .001). Compared with the biopsy-proved cases, the asbestosis cases involved coarser fibrosis (after controlling for disease extent) than the NSIP cases (odds ratio, 2.48; 95% CI: 1.49, 4.11; P < .001) but fibrosis similar to that in the UIP cases. A basal and subpleural distribution of disease was usual in all subgroups but significantly more prevalent (P < .01 to .001) with asbestosis than with UIP or NSIP.CONCLUSION: The thin-section CT pattern of asbestosis closely resembles that of biopsy-proved UIP and differs markedly from that of biopsy-proved NSIP. RSNA 2003.
Original languageEnglish
Pages (from-to)731-736
JournalRadiology
Volume229
Issue number3
DOIs
Publication statusPublished - 2003

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